Virginia Departments of Medical Assistance Services (DMAS)

Notice of Public Comment Period

The Department of Medical Assistance Services (DMAS) welcomes public comment regarding the submission to the U.S. Centers for Medicare and Medicaid Services (CMS) of amended applications for the following 1915(c) Home and Community Based Services (HCBS) Medicaid Waivers: Commonwealth Coordinated Care Plus (CCC+), Community Living (CL), and Family and Individual Supports (FIS) Waivers.

This notice serves to inform interested parties that a 30-day public comment period will run from September 17, 2026 to October 17, 2026.  The 1915(c) HCBS Waiver amendment applications can be found at: https://dmas.virginia.gov/for-members/benefits-and-services/waivers/

The state is requesting amendments to revise the following.  The waiver and appendix in which the item in question is being amended is shared after the item description:

1. Implementing a 56-hour soft cap limit on personal care/assistance with exceptions to request more hours to mirror the CCC+ Waiver (CL, FIS; Appendix C-1/C3)
2. Incorporating services facilitation into the statewide service broker model via the Fiscal-Employer Agent contract and eliminate services facilitation as a standalone service (CCC+, CL, FIS; Transition Plan, Appendix E).  Details of the transition are also available on the DMAS waivers page.
3. Modify program rules for consumer-directed services to allow an individual receiving services to serve as the Employer of Record (EOR) for his own service delivery and designate another individual to perform all or a portion of the duties of the EOR on the individual’s behalf when the individual receiving services is unable to perform such duties or direct his own care (CCC+, CL, FIS; Appendix E)
4. Removing the Eligibility Group “Working Individuals with disabilities who buy into Medicaid (TWWIIA Basic Coverage Group as provided in §1902(a)(10)(A)(ii)(XV) of the Act)" under the waiver (CL, FIS; Appendix B-4)
5. Removing “Legally Responsible Person” as an allowable provider of the Employment and Community Transportation service (CL, FIS; Appendix C1/C3)
6. Correcting requirements for when a legally responsible individual is a paid caregiver and the individual uses the consumer-directed model.  The prior language references a wrong form and an “enhanced enrollment agreement” that has been incorporated into the standard enrollment packet by the fiscal-employer agents (CL, FIS; Appendix C2)
7. Removing the requirement that DMAS staff perform higher level reviews when the individual is found no longer to meet the level of care to remain on the waiver (CCC+; Appendix B-6)
8. Updating service plan quality measures to remove the managed care organizations from performing the review (CCC+; Appendix D Quality Improvement)

The budget item to remove the live-in caregiver exemption from Electronic Visit Verification requirements is not included in this waiver amendment.  CMS has informed DMAS that no waiver amendment is required to make this change.

Instructions for Public Comment Submissions:

Electronic Submission:  Comments should be submitted via the Virginia Town Hall public comment forum.

Or submit via US Postal Mail to:

Department of Medical Assistance Services

ATTN:  Andrew Greer/Senior Policy Analyst – Office of Community Living

Suite 1300

600 East Broad Street

Richmond, VA 23219